1. Disclosures
Successful completion of this continuing education activity includes the following:
Signing into the conference and providing your address
Attending the entire CE activity
Completing the evaluation
You will receive an ed copy of your certificate
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Institute for Medical Quality/California Medical Association (IMQ/CMA) through the joint providership of Cardea and the Washington Chapter of the American Academy of Pediatrics. Cardea is accredited by the IMQ/CMA to provide continuing medical education for physicians.
Cardea designates this live activity for a maximum of 5.5 AMA PRA Category 1 Credits™. Physicians should claim credit commensurate with the extent of their participation in the activity.

2. Disclosures Faculty: Jay Fathi, MD
CME Committee: David Couch; Kathleen Clanon, MD; Johanna Rosenthal, MPH; Pat Blackburn, MPH; Richard Fischer, MD; Sharon Adler, MD.
Richard Fischer, MD is a member of an Organon speaker’s bureau.
Dr. Fischer does not participate in planning in which he has a conflict of interest, and he ensures that any content or speakers he suggests will be free of commercial bias.
None of the other planners and presenters of this CE activity have disclosed any conflict of interest including no relevant financial relationships with any commercial companies pertaining to this CE activity.
There is no commercial support for this presentation.

3. Disclosures
This conference was supported by: Amerigroup, Coordinated Care, Mary Bridge Children’s Hospital, Molina Healthcare, Seattle Children’s, Swedish Pediatrics, and United Healthcare Community Plan

4. Disclosures
Following completion of this session, learners should be able to:
Discuss the implications of behavioral health integration in the Washington Medicaid system.
Describe opportunities for pediatric primary care providers moving forward.

5. Questions?
If you have any questions about this CE activity, contact Margaret Stahl at or (206)

6. Pediatric Population Health Forum November 4, 2017
Value-Based Purchasing in Washington State: Lessons Learned, Addressing the Future – A Health Plan’s Perspective
November 4, 2017

7. Medicaid Managed Care 101 Historically ‘unmanaged care’
Plans’ employees: Social workers, nurses, care managers, community health workers, behavioral health specialists, etc
Member (patient) engagement incentives
5 plans in Washington
Lower costs, higher quality than traditional FFS

8. First Five Years Serving over 250,000 Washingtonians
Coverage includes Medicaid, Foster Care, Health Benefit Exchange
360 Employees statewide, offices in Seattle, Tacoma, Wenatchee, & Yakima
Integrated Behavioral Health in North Central region of Chelan, Douglas and Grant counties, 2018

9. Innovative Programs

10. Apple Health Core Connections
Apple Health Foster Care (AHFC) managed care program, called Apple Health Core Connections.
Launched April 1, 2016.
24,000 members
Have offered over 500 free trainings, helping to educate more than 7,000 partners (foster parents, providers, and other stakeholders).
Launched our Zero Suicide and Emergency Department Diversion Programs.
Added over 2,300 new providers to our network to ensure our foster care children get the care they need.

11. Apple Health Core Connections

12. Behavioral Health Integration
Funded through separate, distinct managed care system for >25 years
Siloed; separate funding stream, separate ‘payor’
Must be ‘integrated’ (funds, management w/ Medicaid plans) via legislative mandate by 2020
HCA with phased/regional approach, w/ RFPs

13. Contracting Full range; from FFS to downside risk
Larger organizations=better able to manage risk (ultimate ‘motivator’--$$)
HCA-contracts w/ plans withhold funding, mandate improved quality scores on select measures
Pediatric asthma (2), WCC, Combo 10
Foster: Adol. well care, ADHD meds (2)

14. Opportunities Plans need you!! Competition
Reimbursement based on quality, vs. volume
Influence policy-legislature, HCA
Challenges

15. jfathi@coordinatedcarehealth.com | CoordinatedCareHealth.com
Contact Information
Jay Fathi, MD
President and CEO
1145 Broadway, Suite 300
Tacoma, WA 98402
Direct:
Toll Free: ext
Fax:
| CoordinatedCareHealth.com